OBJECTIVE To identify growth patterns and gastrointestinal (GI) symptoms in pediatric patients during the first four months after hematopoietic stem cell transplantation (HSCT) and to assess whether an association exists between acute graft-versus-host disease (GVHD) and growth pattern changes or GI symptoms. METHODS A prospective, longitudinal cohort design. METHODS A tertiary children's hospital in a metropolitan area in the southern United States. METHODS A convenience sample of 35 pediatric patients receiving allogeneic HSCT. METHODS Anthropometric measurements were obtained and GI symptoms were surveyed in pediatric patients before HSCT and two and four months after HSCT. METHODS GI symptoms, anthropometric measurements, and presence or absence of acute GVHD. RESULTS All anthropometric measurements showed a significant change over time; height showed an increase, and weight, skinfold triceps, and mid-arm circumference showed a decrease over the fourmonth measurement period. Eight GI symptoms were prevalent over the four months, and the mean severity and distress scores fluctuated minimally during that time. No statistically significant differences were noted in any of the anthropometric measurements or GI symptoms between pediatric patients with and without GVHD. CONCLUSIONS Pediatric patients in the study exhibited poor growth patterns during the four months after HSCT and experienced multiple GI symptoms before and after HSCT. CONCLUSIONS Nurses should be aware of the importance of evaluating growth and symptom experience in all pediatric patients during HSCT recovery and assist in defining treatment plans that will optimize patient health.